Fraud, Error & Waste ™

October 11, 2010 – 12:17 am

By DeusExMacintosh

The penny finally dropped over the weekend when I was telling SL about an unseemly exchange on the blog of Conservative MP Nadine Dorries.

If you Twitter all day, every day about claiming disability benefit in one tweet whist arranging a night out in the pub in the next. If you tweet about claiming six months rent from the social fund whilst tweeting how bad your hangover is and if you stride into political meetings and shout the odds with energy and enthusiasm with no sign of any physical disability and if you claim to work for the Labour party and write porn at the same time as claiming your disability benefit – then don’t expect someone like me not to a) inform the authorities and b) tell you to get off your Twitter and get a job.

On various disability discussion boards and blogs the typical response was “well I guess disabled people aren’t supposed to drink or have a social life” to which SL replied “Well, no. Conservatives don’t accept the Social Model of Disability, remember?”

For those not up to PC speed, there are two competing models of disability currently fighting for political space. The Medical Model looks at disabled people primarily in their roles as patients, with the problem resting in the biological failure responsible for each person’s impairment (my ‘real’ disability would be the nerve damage that prevents me walking properly). In contrast, the Social Model proposes that people are disabled by their society and environment as much as by their physical impairments (my ‘real’ disability would be the lack of flexible work opportunities that would allow me to work at my own pace and/or from home). Reality falls somewhere between the two as you would expect, but it’s the choice of paradigm that will direct public policy which is why this kind of esoterica is so important to those of us who, um, ARE disabled. Until the 1990s it was still an extremely radical notion that people with disabilities might get drunk {gasp} and get laid {swoon} as well as get treatment… potentially for a whole raft of conditions caused by the former two.

When the Nadine Dorries/Humphrey Cushion roadshow hit Guido Fawkes last week after “Dorries” trended on Twitter, I was particularly impressed by the brave way that BendyGirl of the Benefit Scrounging Scum blog bearded the RightWingDeathBeast in its den.

I asked the question on twitter as to whether Nadine was actually suggesting disabled people using twitter should be reported to the DWP because they could use a keyboard and therefore *should* be working. It was posed as a question as I wasn’t entirely sure that whether she meant disabled people (implied by the using a keyboard part) or all people on benefits.

Twitter is a lifeline to disabled people such as myself. Yes, I can use a keyboard, but not without causing further dislocations-I have a genetic disorder which means my joints dislocate almost constantly. Not only does that make day to day life a tad tricky, but it also makes employers wary-I used to work for the NHS in an admin role but lost my job partly because there was no way of preventing large numbers of dislocations/falls etc while I was in work, and partly because I was deemed unfit to work by multiple doctors. Twitter means contact with the world, vital for people who may not be able to get out of bed, let alone their homes.

If Nadine really is concerned about this issue, perhaps she could raise the question about why employers aren’t encouraged to employ disabled people to work from home, thus circumventing the barriers we face in gaining employment such as inability to travel to and from work, lack of appropriate equipment such as wheelchairs-I’ve just waited over a week for the firm contracted to the NHS to come and fix my wheelchair, if I were employed and needing to use it to get to work I’d have lost my job!

Which would you say disables BendyGirl more: having EDS or having to rely on NHS support in order to keep a job?

I then remembered one of David Cameron’s comments on the Andrew Marr show about the Universal Credit that’s been chosen as the shape of welfare reform to come and it clicked.

David Cameron has said “big, bold” Tory welfare reforms will cut “fraud, error and waste” and encourage people back into work.

As I’ve pointed out previously, the official figures issued by the Department for Work and Pensions in no way support the wholesale razing of the benefits system in order to turn back some huge tide of fraud (running at only 3.5% of Incapacity Benefit and 0.5% of Disability Living Allowance by previous counts). When challenged personally by SL about the demonisation of people on benefits back in November 2009 Cameron’s excuse was fraud then too.

David Cameron is the head of the Conservative Party. He may genuinely believe that if you’re not stuck in the house or in a wheelchair, then you’re not really disabled – which would seem to explain the phantom fraudsters. I think it’s fair to say that most people would agree that the boundaries of ‘disability’ inherited via the current benefit rules are drawn too widely to be financially viable while the country is faced with such a huge deficit. Despite being someone with a disability I know that *I* do (who says a turkey won’t vote for Christmas?). Much of the most significant effort in welfare reform has involved redrafting these definitions to be much tighter, most notably by designing the blunt instrument that is the Work Capability Assessment to pry permanently disabled people out of eligibility for long term support entirely. Fifty percent of new ESA claimants are already being told they are fit to work and the DWP has confirmed that it expects almost a quarter of those currently receiving Incapacity Benefit to wind up migrating across to Jobseekers Allowance rather than ESA when the process is trialled in Burnley and Aberdeen from this month. The full migration will be rolled out nationwide from February 2011.

The future for Disability Living Allowance (which is designed to meet the extra costs of disability regardless of whether the claimant works or not – it’s the only reason many of them can afford to) is looking just as grim after the Chancellor was pretty clear about his intentions in the emergency budget this past June.

1.103 The Government will reform the Disability Living Allowance (DLA) to ensure support is targeted on those with the highest medical need [emphasis mine]. The Government will introduce the use of objective medical assessments for all DLA claimants from 2013-14 to ensure payments are only made for as long as a claimant needs them.

(Because the obviously subjective medical assessments for most DLA claimants by ATOS just haven’t been cutting it for the past decade, apparently.)

There has been particular concern at this use of language from groups representing people with developmental conditions such as Downs Syndrome, because whilst their intellectual disability can be major and their personal care requirements intensive, they often have no significant medical needs (such as a feeding tube or medication).

The DEMOS thinktank’s paper Destination Unknown I think captures best the four main issues that are raised when disabled claimants meet the welfare-reform road.

The first is that the government believes cutting benefits will inevitably incentivise work. This takes no account of those who may be unable to work (those with complex needs as well as carers) or those who can only work with personalised support. For these groups, cutting benefits will undermine their quality of life and little else.

The second is that DLA, the only benefit which compensates for the additional costs of living with a disability and is non-means tested, is increasingly mis-represented as an ‘out of work’ benefit and so subject to the same cuts as other benefits to ‘incentivise work’. Again, this is most likely to increase disability poverty rather than incentivise work.

The third is an increasing focus on the medical aspect of disability, to the detriment of the social model – that is, a recognition that social and practical factors have a role to play in a person’s disability, not just their medical impairment. This is leading to the adoption of exclusively medical testing to assess eligibility for incapacity benefits and even DLA – which can only feasibly be based on a calculation of additional living costs.

The fourth and final problem is the government’s exclusive focus on people’s economic contribution to society. Finding employment is seen as the only successful outcome for welfare-to-work providers to achieve. This creates perverse incentives only to help those who are easiest to employ; it overlooks those who may not be able to engage in formal employment but who can contribute to society in other ways (eg volunteering, building social capital), and it also leads to work programmes that do not build people’s capabilities or recognise distance travelled towards employability. This is particularly inappropriate in the current economic climate, where jobs are harder to come by.

These four issues combined create an inflexible and punitive welfare-to-work system, which cannot accurately measure the true distance of disabled people from the labour market. Yet if the complex interaction of medical, psychological, social and practical barriers to work are not understood, it is likely that the subsequent support programmes will not be adequately targeted to address these specific issues – leading to more costly and less effective support.

Mr Cameron, I really, really hope that you genuinely believe that changing the benefits goalposts in the way that you have is justified by an undiscovered reservoir of claimant dishonesty. Otherwise the Fraud, Error and Waste you mention… is YOURS.

26 Comments

the difficulties in employment with unpredictable dodgy days (or hours) challenge typical management ideas, especially for smaller businesses. (I myself have been dodgy today… Still recovering from a couple of very long days last week, and if I work today, I’ll be screwed for the rest of the week).

Large organizations can average things out, so it makes sense for the largest to employ the bulk of those with unpredictable conditions, statistically employing enough people to cover for each other (an example would be it helpdesk folk who can use a dongle if necessary to work from bed in emergencies for short periods where their knowledge of a particular system is critical).

So… Unless a government, in the best position to employ people with difficulties doing a “standard” week, doesn’t prove their employability, leading by example, the state cannot say such people are employable by smaller organizations less able to use the laws of statistics to even things out for unpredictable hours.

So, perhaps cameron should be castigating agencies instead, agencies that cannot offer work that makes use of the skills people with various conditions have to offer. Learning to adapt with a disability or chronic illness shows greater management flexibility and intelligence than most well-paid suits have.

DEM a question: Do you believe it is possible under the proposed changes that benefits will be cut to an unsustainable point without some sort of attendant appeal process? I just cannot believe that the UK would countenance a resulting system where this might be a practical outcome for any specific individual.

And I guess this is a somewhat family blog, so just to say good luck with the gasps and swoons; everyone is entitled to those in their lives.

Disability is surely primarily about one’s ability to function in society — that is what makes it an issue beyond health concerns. Surely then disability policy need two parts — the medical-care bit and the function-in-society bit. Why is this an either-or question at all?

To me (who’s reeling from a week of paralysing virus-induced asthma for the first time in my life) it’s about ability, disability and capability. Disease and disability aren’t defining things in themselves – what matters to the individual affected is what capability they have – what they can do. So would it be more helpful to think of measuring or assessing level of capability rather than disability?

M-H if you don’t want to get out of bed, but you must. If you don’t wish the indignity of being assisted to bath, dress, eat, but you must. If you are unable to smile reassuringly, but you must – then it might be helpful to think of your capabilities, rather than your disabilities. But only if it would all just stop; just for a little while.

[email protected] thinking about the capabilities can be the really depressing, when there is limited opportunity to use them fully.

Harvard Business School Working Knowledge had the wonderful phrase “asymmetrically talented”, bemoaning the waste because of unimaginative management, pointing to a business (a boutique software testing house used by the likes of oracle and microsoft) that adapted it’s own processes and management style to use the asymmetric talents of folk on the autism spectrum: brilliant obsessive testers who could not cope with normal management practices, team meetings… and 75% of testers are on the autism spectrum, and do stuff “normal” people can’t. unfortunately, most managers can only use bricks and mortar, don’t have the imagination of a dry stone waller, cannot make the best use of the resources available.

How many call centres use blind folk, who are the best at interpreting the sounds of customers? That’s just another example of a kind of symmetric talent.

DEMs talents on display here far outstrip most typicals.

I’m lucky finding a boss who appreciates what I am, but then, he knows the bargain he’s getting compared to my hourly charge-out rates 20 years ago, and puts up with my “unreliable” hours. I’m only employable because I’ve found an employer who is prepared to adapt, to both illness and (previously) single-parenthood. such employers are as rare as hens’ teeth.

So excuuuuse me if I don’t have any respect for those who don’t understand the social model.

Dave Bath your comments are uplifting, and I accept completely your examples. As a typical with close experience of an atypical (using your terminology) I hesitated to offer a comment because however much I can care, I can never “be”. And I accept that I probably use a lesser proportion of my typical skills than does a high performing atypical. That said, I’m interested in what the UK is planning because policy tends to leak from one jurisdiction to another if it is seen to be “successful”, but “success” in this particular instance will most probably leave some specific individuals behind. I’m just asking about them.

[email protected] It’s more than obvious you both care and can see the dangers of a “success” caused by shonky definitions.

Regardless of the human cost (which I suspect will be considerable), I think it’s plain dumb as far as money goes, unless the stated aim of financial rectitude is sought by an unstated aim of FOAD that DEM alluded to earlier.

How many have the DVD for the film “Gattaca”? On the dvd is a beautiful standalone short/essay/public-service-announcement that was planned as the coda. It’s /very/ eloquent, beautiful, and /very/ relevant to this discussion, although it concentrates on the subject of the film, genetics, as the name of the film, using four base letters, hints.

I really like my dry-stone-wall metaphor for this, while the attitude of so many political figures and managers is that humans should turn themselves into work units that are almost fungible.

It is such politicians, in my view, that are lazy, dangerously driving societies while suffering with limited vision and heart. The hypocrisy is plain when considering their constant cries for innovation needed for healthy economies, combined with their unwillingness to attempt it themselves.

To expect the assymetrically talented to contribute their fullest without appropriate adjustments of management methods is to assume square pegs are most useful in round holes.

To seek what is impossible is madness: and it is impossible that the bad should not do something of this kind – M.Aurelius V.17

(Ok, that’s probably a misreading of the context that caused those words, but it’s an ambiguity true both ways)

Yes, kvd, if only it would all stop. Sadly, the only release for some people will be the last one, and for me that’s enough reason to try and find humane ways to make the part before it stops as dignified as it can be.

The letter states: “It has come to my attention that while many of my friends and I were at the funeral of our good friend Paul Reekie, aged 48, it would appear that you were giving a speech in Parliament announcing your intentions to slash the benefits paid to the poorest and most vulnerable in our society.

“I thought I would let you know that Paul took his own life. He didn’t leave a note but he laid out two letters on his table. One was notifying him that his housing benefit had been stopped. The other was notifying him that his incapacity benefit had been stopped.

“The reason I’m writing this letter is just so you know the human cost of attacking those on benefits.”

Obviously there is always more than one reason for anyone to commit suicide and we can’t know the full facts in this particular case, but I feel that in principle this may be a warning.

Suicide is more likely to occur when individuals feel they’ve been rejected by their social group (it is seen in animals too), so you add a government campaign that vilifies an already socially isolated group of people, many of whom are told they have little to offer ‘normal’ society if they can’t work or work full-time, and it’s a recipe for disaster.

Informally disabled people are already reporting increased incidences of verbal abuse and even violence. As the pressure steps up, I imagine we’ll be seeing a rise in suicides as people fail to cope with all the uncertainty.

*We’re still arguing about the appropriateness of using the symbol of the Nazi badge given to anti-socials in the concentration camps (the disabled were actually murdered and gassed in hospitals). It’s liable to get you instantly Godwin-ed but there ARE parallels with the Nazi scapegoating of people with disabilities – who were considered “useless eaters”, “life unworthy of life” and compulsorily sterilized – even if not with the the extermination campaign.

For example I personally know people with disabled children who are opposed on principle to government benefits. They are loving and caring parents who would be abominably slurred by such a gesture simply because they have a considered and sincere political view that differs from yours.

For my part I would be very likely to actively oppose an organisation that sought to link my political beliefs with those of Nazism, even if I was sympathetic to their underlying cause and program.

There were two personal experiences that have had a big impact on my thinking in relation to the horrors related by [email protected], and what it means to be human.

It made me think, regardless of species, that sapience and the ability to give and receive love are they key. Almost all intellectually disabled people pass this test, but an /extremely/ small number (I’m guessing a few hundred on the planet) give one pause.

When 16 and doing work experience with a doctor, as well as the joy of seeing a delivery (kept in contact, my daughter went to the “baby”‘s 21st), I was, after a waning, challenged by a 10yo extreme microcephalic, a head smaller than a small dog’s, able to stagger and moan, requiring nasogastric feeding. When looking into those eyes I saw less awareness than any dog, cat, rat, less capability of giving or receiving love or affection. The doctor, with a tiptoey question afterwards, seemed surprised and pleased at the criterion I’d been considering – that love is the key.

In the ealy net, when our web pages publically included the sort of stuff now limited to some facebook friends, I’d listed “favorite disease: Lesch-Nyhan syndrome” which is extremely interesting, and only 60 recorded cases in history when I was studying. Sufferers suffer severe gouty arthriitis, severe intellectual disability (about 60 IQ), a whole lot of other medical problems, and self mutilate (chewing their fingers, and even half their own faces off), while pleading not to have hands untied… Then throw in rage when affection is desired, coprolalia, and the uncontrolled movements of huntington’s chorea.

Well, pre-google, my “home” page was the only mention on the net a carer, a nurse in the US, could find. Of course, I apologised for my gaffe, referred her to the only book I knew… But was met with “it’s ok, no offence taken, and I’m glad to find someone who can give me info. he is aware enough to realize his pain, how horrible his disfigurements, how empty his life will be (life expectancy was under 20), aware enough only to be utterly miserable. He wants to die, and watching his suffering destroys us.”

The Lesch-Nyhan sufferer obviously passed the tests of sapience, and the ability to give and receive love, but knowing nothing but incredible physical and emotional pain, EVERY SINGLE SECOND OF HIS LIFE!!??!! Even just hearing about it, even thumbing this in right now, and the tears are rolling down my cheeks.

These two cases are extreme in different ways. At least the microcephalic wasn’t suffering. For different reasons, I’d be able, in both cases, with much discomfort, to administer an overdose of barbiturates.

If I’d finished medicine, I’d have hoped never to meet less extreme cases, cases on the borderline.

While nothing as extreme an experience as [email protected] reports, I have done substitute/fill-in teaching as Special Needs schools and centres.

Once you have changed the nappy on a 16-year-old boy, you can manage just about anything in that area.

I did find it a bit confronting at first, but it rapidly became much my preferred form of substitute teaching. I discovered that it was easy to care about them and to take them seriously as people. It also increased my contempt for attempts to define people out of the “properly human” on utterly spurious grounds (skin colour, religion, sexuality …) which have nothing to do with the essential elements of what it is to be human.

DEM, you better hope the Hayekian Tories don’t enact their version of the Nuremberg Laws. Here is another Hayek quote that sent a shiver down my spine:

“It is also possible for reasonable people to argue that the ideals of democracy would be better served if say, all the servants of government or all the recipients of public charity were excluded from the vote. If in the Western world universal adult suffrage seems the best arrangement, this does not prove that it is required by some basic principle.”

As a disabled person on welfare, some in the ruling elites would strip you of your citizenship and the right to vote as part of a New Hayekian Order.

Mel, possible is not the same as desirable, and what Hayek says is true. You CAN argue that a property qualification is as good a basis for suffrage as any of the others (I think the Roman objection was that poor people tend to vote to take other people’s money, rich people were more likely to be experienced with economic discipline). Governments can still govern perfectly well and countries run their economies perfectly stably with limited suffrage – the UK had an industrial revolution without women voting and an empire before that with only landholders in the Lords. This was before the Commons even existed eg. Elizabeth the First – the problem would come when attempting to restore this link after a period of proper “universal” suffrage. Yes I’d be against.

Patrick, I didn’t choose the symbol or name the group. For me I think it’s a stumbling block because it shuts down debate as soon as you get anywhere near Nazism. There’s no suggestion that “people who take away welfare are nazis”, the issue is the demonisation of people with disabilities IN ORDER TO EASE WELFARE REFORMS THROUGH THE COURT OF PUBLIC OPINION.

If you want to reform welfare then fine, argue your point on its own economic merit (but personally I see the £10,000 tax-free threshold as a much more efficient way of incentivising work) not by calling claimaints “frauds and scroungers” and suggesting that unless you can be economically active then you have no valid place in society. The latter was the way the Nazis went.

Now because I’m working on a novel in this area I’ve researched a lot about both the T4 “Euthanasia” program and the compulsory sterilization that went before so I’m familiar with a lot of the propaganda that was used to make it more tolerable to the public. Most people won’t be. The point that the Nazis also decided that economic productivity is the solely appropriate measure of social validity is perhaps TOO subtle at this point and thus less effective.

[email protected] said “The point that the Nazis also decided that economic productivity is the solely appropriate measure of social validity is perhaps TOO subtle at this point”

But it’s an extremely pertinent point, as I reckon that such an attitude, slightly altered by changing “production” to “anything that bumps up the GDP and lowers taxes/spending, regardless of long-term stability and current account during my time in office”, is evident in almost every country (apart from the one, possibly two, that talk of Gross National Happiness, but which I suggest could be measured by epidemiological surveys designed to mesh with the WHO ICD and the DSM that look at depression incidence, as the sum of all environmental pressures (including economic) on individuals (and in Oz, collected only once a decade, if that, and not using ICD-compatible tools). I suspect the only real use to many governments of happiness is via consumer sentiment which boosts the economic credentials a government can tout.

Given that wealth and spending have diminishing returns for happiness of individuals, the same money redistributed from a single wealthy person to a number of impoverished persons is a significant increase in the sum of human happiness.

But, of course, if you take money from a disabled person, they aren’t exactly going to be able to turn to crime: it’s tricky to mug someone if you are in a wheelchair or use a walking frame, harder to join mass demonstrations and throw bricks, so crime incidence won’t rise as a result of decreased social support, while the crimes infirm bodies might commit via keyboard are like white-collar crimes (¿maybe neck-brace crimes?), hardly newsworthy, although probably pursued, prosecuted and punished pro-rata far more energetically than the far greater crimes of corporates in The City.

If only the financial regulators had the teeth and support of politicians chasing after massive fraud that the social service authorities have: these impositions on the needy would have little or no pretext to support them, no means of selling them to the larger public.

That highlights the problem. Welfare reform will achieve only one thing: save the govt money. It will probably make those on disability worse off. This certainly happened under Howard here in Aus, where you had drooling schizophrenics expected to find work and other lovely examples of “tough love”.

Most disabled people want to work but our economy is about all efficiency and the simple fact is disabled people cannot be as efficient as the rest. Most of time they will not be as productive, they will incur greater costs for their employers. Then there is a small mountain of studies showing how disabled people are actively discriminated against and if you read the literature the workplace is the key area where they experience discrimination. That is to be expected because in competitive environments we attack the weakest. That is what animals do and it is a central motif of business philosophy. They don’t read “The Art of War” for nothing! In Australia at least the disabled must still compete on the basis of merit. Give with one hand take with the other, all a great big con. So it is not surprising that under Howard disability employment in the public service plummeted. That, incidentally, is concordant with an old study which found that suicides are higher under conservative governments.

I’ve been battling with 3 disabilities all my life and I’m basically done in. The government won’t help, there is even the suggestion they want to pension me off, and there simply is no work for me out there; at least not at present. I’ve given up on that, even my disability employment service, despite my being registered with them for over 6 months, have not done a single thing. The biggest beneficiaries of the disability sector are not the disabled but the employees and organisations in the disability sector. Rent seeking on a grand scale.

Your personal story highlights the inability of the mindset underlying management of most of our society, an inability to make use of asymmetric talents.

I hope you can find something rewarding like I have with one particular boss who recognizes I’m worth the hassle. Perhaps private tuition of secondary students is an option, as this allows scheduling that suits you.

I wonder how many “normals” could deal with the pressure of having employment take up 80 to 90 percent of energy and/or waking hours – they’d be “done in” as you say. They’d need holidays, while folk with difficulties use up all sick leave that eats into holidays.

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